In our previous posts, we emphasized how young women aged less than 55 years constitute a vulnerable population in the context of heart disease. Heart attack is among the leading causes of death kills over 15000 women in this age group each year. Even among those who survive, heart attacks kill young women much in excess of young men. It is likely that less awareness, delayed recognition of symptoms, delay in seeking care, delay in diagnosis by physicians and subsequently delay in treatment are all likely contributing to these healthcare disparities.
In a qualitative study of young women (30-55 years) getting hospitalized with heart attacks, researchers identified the following themes:
- Symptoms of heart attack varied in nature and duration between women and men.
- Young women often inaccurately characterized their own risk of heart disease and attributed their symptoms to non-cardiac causes.
- They delayed seeking care due to competing priorities. They also did not routinely access primary care, including preventive care of heart disease.
- They felt that the healthcare system was not responsive to them leading to delays in diagnosis.
In another study by the same group, analysis of data from 2,009 women and 976 men collected from more than 100 hospitals showed that the majority of both women and men reported chest pain, pressure, tightness, or discomfort as their main heart attack symptom. Yet women were more likely to report other associated symptoms of heart attack, such as indigestion, shortness of breath, palpitations, or pain in the jaw, neck, or arms. Women were also more likely to perceive their symptoms as stress or anxiety, and were more likely to report that their healthcare providers did not think that their symptoms were heart-related.
Other efforts at understanding these disparities include examining the role of the first electrocardiogram (ECG) obtained at the time of the heart attack. It has been found that the treatment gets much delayed when the first ECG is not obtained in the ambulance or when there are certain characteristics of ECG (often seen with high blood pressure) that lead to misdiagnosis of heart attack.
It is imperative to promote better knowledge about heart disease, improve preventive health care, and encourage prompt care-seeking behaviors to improve the epidemiology of heart disease in young women.
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